32 Flashcards
___ __ is a committee that studies and make recommendations about hypertension in the US
JNC 7
commonly known as the “silent killer” ______ results in a systolic BP greater than 140 mm Hg and a diastolic pressure greater than (0 mm HG
hypertension
BP ranges
normal: 160/>100
______ hypertension results from high BP from an unidentifibale cause
primary
_____ hypertension is high BP with identified causes (caused by other diseases)
secondary
______ is abnormal blood fat levels
dyslipidemia
how is high BP viewed?
as a sign a risk factor for atherosclerotic cardiovascular disease or a disease
BP = cardiac output x peripheral resistance
BP = cardiac output x peripheral resistance
the elderly commonly have an increase in BP due to structural and functional changes. theses changes include ____________ and result in decreased elasticity of the major blood vessels?
accumulation of atherosclerotic plaque fragmentation of arterial elastins increased collagen deposits impaired vasodilation
______ ______ hypertension is commonly seen in the elderly. It results in a greater systolic pressure (>140 mm Hg) and a normal diastolic pressure (
isolated systolic hypertension
factors that influence development of hypertension?
increased SNS activity increased reabsorption of sodium chloride and H2O by kidneys increased activity of renin angiotensin system decreased vasodilation insulin resistance
nonmodifiable risk factors for hypertension
genetics family history age
modifiable risk factors of hypertension
smoking obesity physical inactivity dyslipidemia DM microalbuminuria or GFR
symptoms of hypertension
no symptoms other than elevated BP symptoms related to organ damage are seen late and are serious (eye changes, renal damage, MI, cardiac hypertrophy, stoke)
symptoms of potential organ damage?
angina SOB altered speech and vision headaches dizziness balance problems nocturia
how do you assess for hypertension?
H & P exam of retinas labs (to identify organ damage) 12 lead ECG urine test 24 hr urine protein
which labs may be done to assess hypertension?
analysis of Na, K+, creatinine, fasting glucose, total cholesterol, HDLs
ways to reduce hypertension
weight loss reduced alcohol and sodium intake regular physical activity diet high in fruit, veggies, and low fat dairy DASH diet
DASH diet (FYI)
grains: 7-8 servings/day veggies: 4-5 servings/day fruits: 4-5 servings/day lowfat/fat free dairy: 2-3 servings/day meat,fish,poultry:
how long does it take for the taste buds to adapt to changes in salt intake?
2-3 months
for pts with uncomplicated hypertension andn no specific indications for another med, what is the initial med?
thiazide diuretic
s/s of thiazide diuretics
dry mouth thirst weakness/drowsiness electrolyte imbalance postural hypertension
when is the best time to take thiazide diuretics?
in the AM
________ _______ can occur if antihypertensive meds are suddenly stopped
rebound hypertension
______ may be recommeded for the elderly re. hypertension. It will involve treatment with just one med, it will simplify the med regimen and make it less expensive
monotherapy
Recommedations for follow up re. BP measurements
normal: recheck in 2 year prehypertension: recheck in 1 year Stage 1 hypertension: confirm w/in 2 months Stage 2 hypertension: evaluate or refer for care w/in 1 month *if >180/100 mm Hg evaluate and treat w/in 1 week
_______ ______ is when BP >180/120 and must be lowered immediately to prevent damage to target organs
hypertensive emergency
conditions associated with hypertensive emergency
hypertension of pregnancy acute MI dissecting aortic aneurysm intracranial hemorrhage
therapeutic goals of hypertensive emergency
reduce BP 25% in 1st hr reduce to 160/100 over 6 hours then gradual reduction to normal over a period of days w/exception to ischemic stroke and aortic dissection * require frequent monitoring of BP and cardiac status
meds for hypertensive emergency
IV vasodilators b/c they will have an immediate effect
_______ ______ is when BP is very high but no evidence of immediate or progressive target organ damage
hypertensive urgency
elevated BPs associated with severe_____, _______, or _____ are classified as urgencies
headache nosebleeds anxiety
meds for hypertensive urgencies
fast acting oral agents (beta adrenergic blockers, ACE inhibitors, alpha2 agonist)
